Effect of leukocytapheresis therapy using a leukocyte removal filter in Crohn's disease

Eighteen patients with active Crohn's disease were treated with one leukocy tapheresis session per meek for a five-week intensive therapy, decreasing t o one leukocytapheresis session per month for five sessions of initial main tenance therapy. Nutritional indices, inflammatory reactions, flow cytometr y profiles, and cytokine production were also assessed before and after the intensive and initial maintenance therapy. Nine of the patients (50%) atta ined remission at the end of the intensive therapy. The nine non-remission patients had exhibited longer periods of suffering and more severely affect ed sites prior to the therapy. In 14 of 18 patients (77.8%), the nutritiona l indices, Internal Organization of Inflammatory Bowel Disease (IOIBD) scor e and Crohn's Disease Activity Index (CDAI) improved from the pretherapy le vels, but only the remission group (50%) showed improvement in C-reactive p rotein (CRP) and erythrocyte sedimentation rate (ESR). The remission group showed. significantly higher pretherapy CD4(+)CD45(+) cell ratios and inter leukin-2 (IL-2) production than the non-remission group, and significantly lower activated cells.